Abstract
PurposeA healthcare system in any country is rarely the product of one logical policy-making experience, but rather a manifestation of many years of historical development. The purpose of this paper is to examine the characteristics, components, and variables of South Africa’s healthcare system in the context of global patterns. It leverages a dynamic period in South Africa since 1994, and applies a comparative health systems analysis to explain where the country’s healthcare system is, and where it is potentially going.Design/methodology/approachThis paper reviews literature related to South Africa’s healthcare system, outlines its historical development, and discusses three fundamental challenges experienced in the country. This paper also reviews the literature on healthcare system typologies and identifies three framework models that have been used to categorise national healthcare systems since the 1970s. This paper then discusses the categorisation of South Africa’s healthcare system in these models, in comparison to Canada and the USA.FindingsThis paper finds that the framework models are useful tools for comparative analysis of healthcare systems. However, any use of such typologies should be done with the awareness that national healthcare systems are not isolated entities because they function within a larger context. They are not static, since they are constantly evolving with many nuances, even with very similar healthcare system categorisations.Originality/valueThis paper charts the trajectory of change in the South African healthcare system, and demonstrates that the change process must keep internal conditions in mind if the outcome is to be successful. Imitating policies of countries with well-functioning systems, without regard to local realities, may not work, as the government attempts to usher in changes within a short span of time.
Highlights
According to the World Health Organization (2000), health systems consist of “all the people and actions whose primary purpose is to improve health
In the Roemer framework model, South Africa and the USA are within the same general category, even though they are differentiated by economic level
Using the example of South Africa’s healthcare system, this paper demonstrates that healthcare systems of countries are highly vibrant systems that are sensitive to changes in both the external and internal environmental dynamics (Van Rensburg, 2004, p. 10)
Summary
According to the World Health Organization (2000), health systems consist of “all the people and actions whose primary purpose is to improve health. They may be integrated and centrally directed, but often they are not” Among the people involved in modern healthcare are doctors and nurses, as well as allied health professionals such as physiotherapists, nutritionists, or occupational therapists, among others. The full terms of this licence may be seen at http://creativecommons.org/licences/by/4.0/legalcode
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